Dealer form Step 1 of 2 50% "All Billet, All The Time." Liberty Forged Dealer ApplicationIs business operating at the owner's residence?(Required) Yes NO Are you an existing customer?(Required) Yes No Do you have/had any existing or previous account with Liberty Forged?(Required) Yes No If yes, list name:(Required)Company Name (Trade / DBA):(Required)Company Name (Legal):(Required)Business Leal Structure:(Required) Partnership LLC Corp Federal Employer ID Number (FEIN):(Required)Year established by current ownership:(Required)Shipping Address:(Required) Street Address City State / Province / Region ZIP / Postal Code Billing Address: (Don't fill out if same)(Required) Street Address City State / Province / Region ZIP / Postal Code Applicant Information Contact Information: Sales Name:(Required)Sales Phone:(Required)Sales Email:(Required)Please attach W9:(Required)Max. file size: 256 MB. Please refer to the following summary and initial to acknowledge:Initial buy-in is a minimum of 3 set order to obtain dealer status.(Required)Annual purchase of $20,000 minimum to maintain dealer status.(Required)Base prices do not include upcharges for things like Powder Coat, Custom Powder Coat, Custom Center Cap Logos and Freight.(Required)All dealer agreements are non-exclusive.(Required)Liberty Forged reserves the sole and explicit right to accept or deny all applications.(Required)Liberty Forged reserves the sole and explicit right to remove any dealers at any point for not meeting requirements.(Required)By signing this application, I acknowledge that I have read the basic requirements as outlined by Liberty Forged LLC and agree with those basic terms as set forth. Further, I acknowledge that all information provided in this application is true and correct to the best of my knowledge and that knowingly or willfully presenting false information in this application will result in the request being immediately rejected. Liberty Forged reserves the sole right to accept or reject all applications. Please allow up to seven (7) days for Liberty Forged to review your application and verify the information contained herein. If you have any questions regarding the status of your application, please email [email protected] and you will receive immediate updates. Company Representative (Printed):(Required)Company Representative (Signature):(Required)Date Signed:(Required) MM slash DD slash YYYY
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